Pneumonia

Pneumonia is an inflammation of the lungs usually caused by bacteria, viruses, fungi or other organisms. Elderly people are more susceptible to pneumonia for several reasons. Often they already suffer from co-morbid conditions such as heart disease, which means they don’t tolerate infection as well as younger people. Age also causes a decrease in an older person’s immune system response, this weakening their defense.

SymptomsCausesTypesPrognosisDiagnosisTreatmentPreventionTips for Caregivers

Pneumonia is caused by more than thirty types of organisms; these different strains mean that symptoms can vary

Pneumonia is caused by more than thirty types of organisms; these different strains mean that symptoms can vary from case to case. However, the following symptoms can signal a bout of pneumonia:

  • Malaise or feeling weak
  • Cough
  • Green or yellow sputum
  • Pain in the chest
  • Confusion
  • Fever
  • Chills
  • Shortness of breath

Viruses, bacteria, a fungus, or parasites or other organisms can cause pneumonia.

  • Viruses, bacteria, a fungus, or parasites or other organisms can cause pneumonia. In most cases, the specific organism identified is usually the bacteria Streptococcus pneumonia. Viruses, such as influenza and respiratory syncytial virus (RSV) can cause pneumonia. In people who have impaired immune systems, pneumonia may be caused by other organisms, including some forms of fungi, such as Pneumocystis jiroveci.An older person may get pneumonia through the following:
    • After he/she breathes infected air particles into his/her lungs.
    • During or after a viral upper respiratory infection, such as a cold or influenza (flu).
    • As a complication of a viral illness, such as measles or chickenpox.
    • If he/she breathes large amount of food, gastric juices from the stomach, or vomits into the lungs (aspiration pneumonia). This can happen when the older person has had a medical condition that affects the ability to swallow such as a seizure or a stroke.
  • If he/she breathe large amounts of food, gastric juices from the stomach, or vomit into the lungs (aspiration pneumonia). This can happen when the older person has had a medical condition that affects the ability to swallow, such as a seizure or a stroke.

There are five major types of pneumonia which are:

Bacterial Pneumonia: The most common cause of bacterial pneumonia is streptococcus pneumonia. Bacterial pneumonia can also be caused by Chlamydophila pneumonia or legionella pneumophila. Pneumocystis jiroveci pneumonia is sometimes seen in those who have weak immune systems, due to illnesses like AIDS or cancer.

Viral Pneumonia: In most cases, respiratory viruses can cause pneumonia, especially in young children and the elderly. Pneumonia is usually not serious and lasts a short time.

Mycoplasma Pneumonia: Mycoplasmas are not viruses or bacteria, but they have traits common to both. They are the smallest agents of disease that affect humans.

Other types of Pneumonia: Many additional types of pneumonia affect immune-compromised individuals. Tuberculosis and pneumocystis pneumonia (PCP) generally affect persons with AIDS. Less common types of pneumonia can also be serious.

Most people with pneumonia improve after three to five days of antibiotic treatment, but a mild cough and fatigue can last longer, maybe up to a month. Patients who require treatment in a hospital may take longer to see improvement.

Pneumonia can also be fatal. Pneumonia is more likely to be fatal in the elderly or those with chronic medical conditions or a weakened immune system.

Pneumonia can be easily overlooked as the cause of an illness because it often resembles a cold or the flu. However, it usually lasts longer and symptoms seem more severe than these other conditions.

  • Detailed Patient History: To determine whether or not an elder has pneumonia, doctors generally inquire about a patient’s signs and symptoms.
  • Physical Exam: Crackling and bubbling sounds in the chest during inhalation are usually indicators of pneumonia. Wheezing may also be present.
  • Diagnostic Tests: Chest X-rays can be used to determine if infection is present in the lungs. Blood tests can provide a better picture of the type of pneumonia.

Additional tests that may be required include:

  • Chest computed tomography (CT scan): This painless test provides a clear and precise picture of the chest and lungs.
  • Sputum test: This test will examine the sputum (the mucus coughed up) to determine what type of pneumonia is present.
  • Pleural fluid test: If there is fluid apparent in the pleural space (the space between the tissue that covers the outside of the lungs and the inside of the chest cavity), a fluid sample can be taken to help determine if the pneumonia is bacterial or viral.
  • Pulse oximetry: This test measures the level of oxygen blood saturation by attaching a small sensor to the finger. Pneumonia can prevent normal oxygenation of blood.
  • Bronchoscopy: When antibiotics fail, this method is used to view the airways inside the lungs to determine if blocked airways are contributing to the pneumonia.

The type of treatment prescribed for pneumonia primarily depends on what type of pneumonia is present and its severity. In many cases, pneumonia can be treated at home.

  • General Treatment: The typical treatment plan for pneumonia includes taking all prescribed medications and participating in follow-up care.
  • Treating Bacterial Pneumonia: Antibiotics are used to treat this type of pneumonia. Antibiotics should be taken as directed. If antibiotics are ceased before treatment is complete, the pneumonia may return. Most people will improve after one to three days of treatment.
  • Treating Viral Pneumonia: Antibiotics are useless if a virus is the cause of pneumonia. However, antiviral drugs can help treat the condition. Symptoms usually improve within one to three weeks.

It is not possible to prevent all types of pneumonia, but one can take steps to reduce the chance of contracting the condition by quitting smoking, practicing good hand-washing and avoiding contact with people who have cold, flu, or other infections.

There are two types of vaccine, PPSV23, a pneumococcal polysaccharide vaccine against 23 types of the bacteria, and PCV13, a pneumococcal conjugate vaccine that protects against 13 types of the bacteria. It is recommended now that all adults over 65 receive doses of each vaccine, starting with PCV13 and followed by PCV23 within six months to 1 year. PPSV23 is recommended for all the people over the age of 65 and everybody over the age of 2 with a weakened immune system or certain chronic conditions.

Avoidance of areas where fungal pathogens are endemic is recommended to prevent fungal pneumonias. There is no antifungal vaccine available; however, for some high-risk patients, some clinicians have recommended prophylactic antifungal drugs.

  • Flu predisposes elderly people to pneumonia, so the numbers of pneumonia cases tend to spike during flu season
  • All people over age 65 get an annual flu shot, as well as a pneumococcal vaccine
  • Caregivers should also be vaccinated, to avoid getting sick themselves and passing the illness to their elderly parents
  • Regular exercise is also key to keeping seniors healthy
Current Category: Pneumonia
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